Saudi Cultural Missions Theses & Dissertations
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Item Restricted Delivering Immersive Virtual Reality as an Intervention to Patients with Chronic Low Back Pain in The Kingdom of Saudi Arabia: A Mixed-Methods Feasibility Study(Saudi Digital Library, 2025) Alotibi, Fahad Salman; Hendrick, Paul; Moffatt, FionaBackground: Chronic low back pain (CLBP) has been recognised as a leading cause of disability in adults for three decades. Literature constantly calls for improved CLBP healthcare services. Immersive virtual reality (IVR) can encourage patients with CLBP to engage in exercise regimes and remain active, but the feasibility of IVR in the Kingdom of Saudi Arabia (KSA) among patients with CLBP is unknown. Aims: To investigate the feasibility of delivering IVR to patients with CLBP in the KSA. Method: Two studies were conducted. Part 1: an umbrella review of systematic reviews (SRs) aimed to identify, summarise, synthesise and critically appraise existing SRs regarding the effectiveness of VR in individuals with chronic MSK pain and disability, focusing on CLBP. The results of this previous review, along with patients and public involvement, informed the design of a protocol for testing the feasibility of delivering IVR to treat patients with CLBP in the Saudi context. Part 2: a sequential explanatory mixed-methods feasibility study aimed to examine predefined progression criteria of the feasibility of delivering IVR to a sample of individuals with CLBP and explore their experiences along with relevant healthcare practitioners in the Saudi context in outpatient department (OPD) settings. The feasibility study adopted a sequential explanatory mixed-methods design comprising two phases: the quantitative (Phase 1) and qualitative (Phase 2). Findings: Part 1: the overall confidence in the identified SRs ranged from low to critically low, whereas the certainty in the body of evidence ranged from moderate to very low. Although the results suggest that VR, either as an alternative form of treatment or in combination with other interventions, may provide a short-term positive impact on patient-reported outcomes for pain in patients with chronic primary MSK pain, it remains uncertain which specific VR intervention shows the most promise, as the included SRs grouped various types of VR together. However, results on patient-reported outcomes for disability and kinesiophobia were inconsistent. Adverse events included motion sickness, nausea, and vertigo. Part 2, Phase 1: the recruited patients included 31 males and two females over 12 weeks. The feasibility a priori criteria were met for recruitment, retention, dropout, completeness of questionnaire data, and treatment compliance and fidelity. No serious adverse events were experienced among patients. However, some incidences of non-serious, short-lasting, minor adverse events were reported. Part 2, Phase 2: analysis of qualitative data from interviews with eight male patients and three physiotherapists (the latter of whom comprised two males and one female) revealed four overlapping themes: sociocultural considerations, facilitators, barriers, and feasibility. Sociocultural considerations included visual (e.g., avatar outfit), auditory (e.g., music), contextual (e.g., same-gender IVR administrator), and IVR-specific factors (e.g., feeling ashamed to play like a child). From the patients’ perspectives, the study process and materials were described as feasible, and recommendations were discussed for IVR implementation. From the physiotherapists’ perspectives, recommendations for the success of IVR integration into the KSA healthcare system included using multiple devices and an efficient scheduling system. Facilitators, from the patients’ perspectives, included ‘positive IVR experience,’ and ‘IVR is motivational.’ Additionally, from patients’ and physiotherapists’ perspectives, facilitators included ‘IVR is therapeutically useful, easy to use, and tolerable.’ Barriers to delivering IVR, from the patients’ perspectives, were ‘personal challenges’ related to time and travel. Furthermore, the physiotherapists-related barrier was ‘time-consuming for physiotherapists.’ Moreover, from both patients’ and physiotherapists’ perspectives, barriers included ‘lack of knowledge’ and ‘support and infrastructure issues.’ Implications: The results indicate that IVR was feasible, acceptable, and tolerable among patients with CLBP and healthcare professionals in the KSA within OPD settings. IVR can be utilised to support patients’ engagement in physiotherapy OPD settings. Further research focusing on the effectiveness is warranted in this field. Furthermore, further mixed-methods research within the context of this study and other MSK conditions is warranted in the Saudi Context to reveal more sociocultural considerations.9 0Item Restricted Barriers and Facilitators to Uptake of Cardiac Rehabilitation Following Percutaneous Coronary Intervention in Saudi Arabia(Saudi Digital Library, 2025-06-17) Almoghairi, Ahmed Mohammed A; Duff, Jed; O'Brien, JaneBackground Cardiovascular disease remains the foremost cause of mortality and a major contributor to morbidity globally, with coronary heart disease being particularly prevalent across populations. In the Kingdom of Saudi Arabia, cardiovascular disease accounts for approximately 45% of all deaths, with coronary diseases as the leading cause. Treatment for coronary diseases typically involves lifestyle modifications and medications to manage symptoms. However, when these are insufficient, percutaneous coronary intervention is employed to restore blood flow to the heart muscle. Even with these interventions, patients who do not alter their lifestyle post procedure remain at high risk for recurrent cardiac events and rehospitalisation imposing tremendous burdens on health systems. Thus, effective post-discharge care is crucial, particularly through cardiac rehabilitation programs. Despite their proven benefits and cost-effectiveness, these programs are globally underutilised due to multiple barriers at the patient, clinician, and healthcare system levels. In the Kingdom of Saudi Arabia, the paucity of research further limits understanding of adherence to secondary prevention measures and barriers to the uptake of cardiac rehabilitation among patients with coronary heart disease. This backdrop sets the stage for this study to explore the country’s understudied areas of cardiology care. Aim This research project aims to identify the difficulties and opportunities in providing cardiac rehabilitation services to patients with coronary heart disease following percutaneous coronary intervention in cardiac centres across Saudi Arabia. Methods This PhD thesis employed a multiphase methodological approach beginning with conducting a systematic scoping review using the Joanna Briggs Institute methodology to identify effective interventions to promote uptake of cardiac rehabilitation (objective 1). This review systematically searched seven online databases for English-language articles published in the last decade, extending until October 2024. Reviewers independently assessed eligibility, and data extraction followed the Template for Intervention Description and Replication and PRISMA guidelines. The subsequent phase utilised a cross-sectional survey employing computer-assisted telephone interviews to collect insights from Saudi patients with coronary disease who underwent revascularisation at the Prince Sultan Cardiac Center in Riyadh and were clinically eligible for cardiac rehabilitation (objective 2). The study collected data from patients one-month post-procedure and aimed to evaluate their adherence to secondary prevention behaviours and identify their challenges when enrolling in cardiac rehabilitation programs. The further phase involved an observational cross-sectional study that distributed an online survey to cardiologists and cardiology fellows across Saudi Arabia (objective 3). This questionnaire was disseminated during the Saudi Heart Association's annual conference in October 2023 and extended through various social media platforms. It assessed participants' self-reported knowledge, attitudes, and practices regarding cardiac rehabilitation and determined impediments to their referral practice. Participants were required to have a minimum of six months of clinical experience managing patients with coronary disease post-percutaneous coronary intervention. The final phase involved a qualitative study using an interpretive descriptive approach, featuring recorded semi-structured interviews with key decision-makers in cardiology care within Saudi Arabia (objective 4). It aimed to identify the health system level challenges and potential enablers for the uptake of cardiac rehabilitation in the country. The analysis of these interviews was structured around the updated Consolidated Framework for Implementation Research, which guided the identification of themes. Results The scoping review highlighted that home-based cardiac rehabilitation internationally led to higher patient engagement and adherence to secondary prevention post interventions and effectively overcame several challenges at patient and health system levels. The observational study in phase two included 104 post-procedures Saudi patients with coronary diseases and showed a concerning prevalence of cardiac risk factors and significantly low adherence to secondary prevention measures, with only 10.6% being referred to cardiac rehabilitation. The most-cited barriers to enrolment in cardiac rehabilitation by included patients were inadequate program endorsement by cardiologists, absence of communication with cardiac rehabilitation care providers, and geographic distance to the service site. The subsequent survey involving 106 cardiologists revealed that, while they were knowledgeable about cardiac rehabilitation services and their benefits for patients following interventions, there was notable uncertainty regarding the quality of local services. This ambiguity, combined with unclear patient pathways and the limited availability of programs in practice areas, contributed to the reluctance of cardiac specialists to recommend these programs to their eligible patients. The last research examination interviewed nine policymakers and revealed systemic issues such as insufficient facilities, lack of cardiologists’ knowledge about cardiac rehabilitation, and shortage of qualified staff. This thesis recommends strategic improvements for consideration by the national healthcare system in Saudi Arabia to facilitate broader and successful implementation of cardiac rehabilitation programs. These reforms incorporate revising patient discharge protocols, enhancing the education and training of clinicians on cardiac rehabilitation, implementing effective referral systems, and ensuring equitable expansion of services across all regions. It also advocates for the adoption of innovative models of cardiac rehabilitation such as home-based and telerehabilitation programs, the development of supportive cardiac rehabilitation policies and regulations, and the engagement of higher authorities to drive these transformative changes. Conclusion This PhD thesis thoroughly examines effective interventions for cardiac rehabilitation delivery and identifies home-based models as effective alternatives to the underutilised traditional programs. It reveals critical findings pinpointing low adherence to secondary prevention measures and enrolment in cardiac rehabilitation programs among Saudi patients with coronary heart disease following percutaneous coronary intervention, primarily due to inadequate healthcare professional support and limited program accessibility. It indicates a significant knowledge practice gap in cardiologists within Saudi Arabia which affected the nationwide endorsement of cardiac rehabilitation. It uncovered systemic challenges necessitating urgent national reforms to boost program capacity, enhance healthcare professionals’ understanding of cardiac rehabilitation, and attract qualified personnel to the services. The integrated insights from the conducted studies significantly improve the understanding of cardiac rehabilitation utilisation within Saudi Arabia and similar contexts, laying a foundation for ongoing research to design, refine, test and implement innovative cardiac rehabilitation models, and encourage more international collaborative efforts for comparative studies of these innovative models.23 0Item Restricted Investigating Organisational Success Determinants for Adoption of Innovation in Saudi Deep Technology and Environmental Engineering Businesses(Saudi Digital Library, 2024-02-01) Badereg, Ahmad Talal; El-Hamalawi, Ashraf; Fotwe, Francis EdumPerformance within organisations aims to create a structure to boost working conditions and employees’ attitudes. Innovation performance is the process that encompasses the generation of ideas and strategies, as well as presentation and development and developing innovation from a resource-based perspective. Companies should invest significantly to sustain and enhance capabilities for innovation. Goals of innovation include increased market profile, high quality, and increased revenue, profitability, discovering new horizons, attracting more investment, motivating and stimulating employees and maintaining a competitive edge in the complex marketplace. The aim of this research is to critically investigate innovation enterprise mechanisms and success determinants for Saudi deep technology environmental engineering businesses, in order to develop a validated framework for innovation enhancement practices in the Kingdom. This research was carried out through an empirical study designed for the purpose. Wallach’s 3-Dimensional model and the Organisational Culture Index (OCI) were used for survey questionnaires in order to identify the Kingdom’s cultural profile (e.g. bureaucratic, innovative, supportive) and validating the developed conceptual framework. Semi-structured interviews were conducted to seek information and knowledge through describing the central theme. Case studies included deep technology environmental engineering businesses and government-based companies in the Kingdom. Initial results were promising and paving the way for innovation; however, most of the companies were facing enormous challenges, as use/implementation of innovation practices were ranked low amongst deep technology environmental engineering businesses in Saudi Arabia. Although, most of the variables were identified in the conceptual framework, it has noted that the current culture was not rather innovative or supportive but bureaucratic. Most significant challenges were lack of leadership, shortages of skills, managerial capacity and capability, lack of appropriate KPIs (Key Performance Indicators) and readiness of organisation in the Kingdom. The Conceptual framework was validated via different iterations using empirical data. The result of this work is the first empirical study in the Kingdom which has made an attempt to investigate innovation practices among deep technology companies and proposing a validated conceptual framework for successful implementation of innovation-based culture. Finally, recommendations were provided to overcome the key challenges which were identified in this research. The recommendations include training and 5 development program for improving skills, development of leadership, reforms in Saudi Educational system and adopt appropriate KPIs for innovation.7 0Item Restricted Elevating Primary Healthcare in Saudi Arabia: A Strategic Implementation of National Standards(University College London, 2025) Alsoqair, Yara; John, PreethiPurpose This comprehensive exploration enables the identification of gaps, trends, and seminal works that shape the discourse within the health sector. Moreover, the analysis of diverse strategies for issues identified by the client adds a pragmatic layer to the project, bridging theoretical insights with real-world applicability. Methodology Balancing the need for transparency with confidentiality and ensuring that research outcomes were used responsibly and for the benefit of the public were integral to this consultancy project’s approach. Findings The study identifies several determinants, including the essence of primary care accessibility, elevating primary care quality, nurturing the primary care workforce, harnessing Health Information Technology (HIT), regulatory compliance, diverse stakeholder perspectives, and crisis preparedness and response.28 0Item Restricted Corporate Social Responsibility in an Islamic Environment: Analysis of Ramadan and Eid Al-Fitr Advertisements for STC, Zain, and Mobily Telecom Company from the Lens of Legitimacy Theory(Virginia Commonwealth University, 2024) Albarakati, Entesar; Song, BaobaoCORPORATE SOCIAL RESPONSIBILITY IN AN ISLAMIC ENVIRONMENT: ANALYSIS OF RAMADAN AND EID AL-FITR ADVERTISEMENTS FOR STC, ZAIN, AND MOBILY TELECOM COMPANY FROM THE LENS OF LEGITIMACY THEORY By Entesar Albarakati, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, at Virginia Commonwealth University. Virginia Commonwealth University, 2024 Major Director: Baobao Song, Assistant Professor, Richard T. Robertson School of Media and Culture The concept of corporate social responsibility (CSR) has gained popularity in recent decades as the number of corporations that engage in CSR continues to grow. In the last 20 years the breadth of CSR has expanded substantially, not only in terms of the variety, scope, and influence of business policies, but also in terms of scholarly research. Despite the expansion of the field of CSR, Islamic corporate social responsibility (ICSR) still receives less attention in academic research than traditional CSR, perhaps because of the lack of defining boundaries and basic principles of ICSR. In Islamic countries such as the Middle East, there exist notable variations in cultural, economic, political, and religious traditions. Hence, the applicability of the existing body of research on CSR in other regions cannot be readily extrapolated to the Middle East (ME). This research aims to investigate CSR messages in an Islamic environment by assessing the content of advertisements for three telecom communication companies operating in Saudi Arabia during Ramadan and Eid al-Fitr. The study used a quantitative content analysis technique guided by legitimacy theory to answer the research questions. A total of 51 advertisements issued from 2008 to 2023 were examined. The results revealed that the bulk of CSR advertisements were concentrated between 2016 and 2023; they also showed the importance of advertising during Ramadan and Eid al-Fitr, as the rate of ad views reached millions, confirming the importance of these two religious occasions. The study dealt with three primary axes that were included in CSR ads—first, legitimacy. The results demonstrated that moral legitimacy (23%) was the most common type of legitimacy included in CSR ads, followed by pragmatic legitimacy (13%), followed by practical legitimacy (5.9%). Second, religious customs and values were included in 58.8% of advertisements. Third, SDSGs—29.4% of ads included SDGs. This study and previous studies confirm that CSR in Islam still receives less attention in academic research compared to traditional corporate social responsibility. Therefore, this study recommends establishing specific limits and basic principles for corporate social responsibility in Islam. This is done by defining established standards and guidelines for measuring and evaluating CSR practices in Islam. The study recommends diversifying the method, industries, religious customs and values, and geographical and economic regions in Islamic countries,22 0Item Restricted IPO Regulation in Saudi Arabia: A Look into IPO Listing Requirements and their Future Suitability(University of Edinburgh, 2024) Mushaikh, Yousuf; Hood, ParkerThis thesis discusses the KSA capital market in light of the recent rise of private companies pursuing initial public offerings. The thesis discusses the history of KSA's capital market and its continuous growth in light of Vision 2030 and its realization programs. The thesis provides an overview of the listing requirements for IPOs in both Tadawul's main market and NOMU and assesses them in a comparative manner with UK's IPO listing rules. The aim of this thesis is to analyse IPO listing requirements in KSA and their role in enabling private companies going public. The thesis looks into the potential difficulties private companies may face in going public and analyses them while also looking into the potential of introducing SPACs in KSA to further grow the capital market, in line with Vision 2030's goals.39 0Item Restricted THE WAQFS OF THE FURQAN ASSOCIATION IN TAIF FOR MEMORIZING THE QURAN AND ITS ROLE IN ACHIEVING SUSTAINABLE DEVELOPMENT(UNIVERSITY OF TECHNOLOGY MALAYS, 2022-09-30) Almalki, Abdulrahman Saee; Yaacob, AhmadSustainable development encompasses all dimensions of human progress and aims to improve living conditions without increasing the use of natural resources. The most significant challenge of sustainable development is the eradication of poverty, as poverty may lead to various societal issues, including blasphemy. It is known that poverty is prevalent among Muslims and is more common in Muslim-majority countries compared to others. Therefore, the main question is: what is the role of Islamic waqf institutions in addressing this issue, and does the Furqan Association have a role in solving it. The researcher employed a qualitative approach, utilizing interviews and library research to collect and analyze the data. The official data published by the association on its website, including administrative, financial, and organizational information, was used, in addition to conducting interviews. Interviews were conducted with six of the association's employees, and the data was analyzed using MAXQDA software to determine the state of waqf, the challenges to its development and growth, as well as its impact on sustainable development. The study reached several findings, the most important of which is that Islamic waqf has a clear impact on achieving sustainable development in general, and in the Kingdom of Saudi Arabia in particular. This finding also applies to the Furqan Association for Qur'an Memorization in Taif. Another result is that increasing waqf assets in both quantity and quality will lead to greater contributions to sustainable development and improved quality of education. Among the key recommendations is to increase support for the association's waqf projects, given their significant role in promoting sustainable development. It is also recommended that sustainable development be prioritized as one of the association's primary goals, in line with Saudi Arabia's Vision 2030 for sustainable development Keywords: Sustainable Development, Kingdom of Saudi Arabia, Islamic Waqf, Furqan Association for Qur'an13 0Item Restricted Health and Safety in the Construction Industry at the United Kingdom and the Kingdom of Saudi Arabia(University of Greenwich, 2017-09-01) Wafa, Hatem; Smis, DeborahHazards in the construction industry have expensive direct and indirect project costs due to accidents. As such, demand to find solutions to these problems have escalated in the past three decades. Project cost, quality, safety, and duration are core elements that contribute to project success however firms still cut their allocated safety budgets. Results show these firms have more injuries and go over budget demonstrating they have a strong relationship between safety and performance. This research reviewed the safety legislation in the United Kingdom (UK) and the Kingdom of Saudi Arabia (KSA) as well as the accident rates in these two countries, reviewed the literature on safety practises in the construction industry in the KSA and, investigated safety practises in a large railway project in the KSA. The results from the literature review showed that despite similarities in construction safety legislation in the UK and the KSA, the KSA has a significantly higher rate of accidents. Also, finding from the literature review as well as the results from the survey on safety practises in the large railway project in the KSA showed that safety legislation was not completely followed in the KSA. To improve safety practises in the KSA, this research has developed a set of recommendation based on literature review and the study of safety practises in the large railway project in the KSA to help improve safety practises in the construction industry in the KSA.30 0Item Restricted Determinants of Giftedness within the Family as Indicators of Creative Thinking and Creative Personality among Gifted Students in the Kingdom of Saudi Arabia(Arabian Gulf University, 2024-02-25) ALjohani, Hind; Ayoub, Alaa Eldin; Alabbasi, AhmedThe aim of the research is to identify the significance of the differences in the creative product, the creative process, trends and values towards creativity and the creative personality among gifted students due to family factors and extracurricular activities, and to determine the predictive ability of family factors and extracurricular activities in the creative product, the creative process, trends and values towards creativity and the creative personality. The descriptive approach was used, and the research sample consisted of (190) gifted secondary school students in the Kingdom of Saudi Arabia, who were selected using the available sample method from several different schools and regions, namely the Medina region, the Qassim region, the Riyadh region, and the Eastern region. The sample distribution according to the family size variable was (41.6%) of small size, (39.5%) medium size, and (18.9%) large size, and the distribution of the study sample according to the birth order variable was the highest percentage in the middle order with (56.8%) ), then in last place with a rate of (24.7%). The distribution of the sample according to the variable of the father’s educational level was concentrated at the university level at a rate of (63.2%), and according to the variable of the mother’s educational level it was concentrated at the university level at a rate of (70.0%). The majority of the sample resided with their parents (87.4%). The research used the Divergent Thinking Scale, the Creative Activities and Achievements Scale, and the How to Describe Yourself Scale. The results showed that the family size variable was able to predict the level of creative product among students. The birth order variable was able to statistically significantly predict the level of creative product, the level of fluency, the level of flexibility, and the level of creative personality. The variable of the father's educational level was able to predict statistically significantly the level of the creative process, and the variable of the mother's educational level was able to predict statistically significantly the level of the creative personality. It was also shown that extracurricular activities during study and summer extracurricular activities were able to predict statistically significantly the level of creative product, and that the variable of extracurricular activities during study was able to predict statistically significantly the level of creative personality among gifted students, and that the variable summer extracurricular activities was able to predict the level of fluency and the level of flexibility. . Based on the results, the research recommended increasing interest in building training programs in the areas of creative thinking and creative personality for gifted students in Saudi schools, and increasing interest in school extracurricular activities and summer extracurricular activities provided to gifted students.55 0Item Restricted Social Trust in Property Ownership: A Study in The Kingdom of Saudi Arabia(University of Southampton, 2024-06-21) Altamimi, Manar; Wills, Gary; Al Hashimy, NawfalOwnership refers to the legal rights, obligations, and interests, all of which are formally recognised by a legal system. The regulation of property ownership dictates access to and control over land and other resources. In modern society, property ownership relies heavily on technology for identifying, record-keeping, and verifying property ownership to ensure compliance with the legal system. However, this reliance on technology introduces challenges such as fraud, incorrect information, and potential challenges like double sales as technology continues to advance. Further challenges can be encountered when it is regulated by several governmental entities to secure ownership. This research focuses specifically on the legal system in the Kingdom of Saudi Arabia, acknowledging the global nature of challenges but tailoring the investigation to the unique context of this region. To address the challenges inherent in the land registration system, the research proposes a STF. Unlike existing approaches that primarily lean on technology, this framework delves into the underlying factors contributing to challenges and identifies key considerations for establishing a safe process for transferring ownership. The framework encompasses four categories of social needs for trusting systems: organisation, provenance, technical, and legal. Each category comprises a set of factors that should be considered during the development of the system. Importantly, this framework is designed in alignment with the interests of stakeholders who regularly engage with the systems and is validated by experts in governmental entities. The validation process is based on qualitative data and analyse using thematic analysis. The STF supports the analysis of user requirement specifications to identify the necessary requirements. The user needs are analysed to identify the requirements needed using the scenario-based approach of transferring ownership, with the knowledge that this scenario avoids the challenges outlined. The identified requirements serve as essential inputs for constructing models using the Event-B formal methods, a mathematical approach that ensures the correctness and consistency of the requirements. The formal model is built using a correctness-by-construction methodology, that allows the deduction of assurances for the trustworthy process of transferring ownership. The model undergoes evaluation by formal method specialists to guarantee the construction of an accurate model through the utilisation of discount expert review. Applying the formal method significantly affects system development. It aids in articulating implicit assumptions and clarifying system requirements. They highlight challenges with system requirements, and their rigour helps to understand the challenge better. Additionally, the formal method reduces implementation time and error by a large amount.18 0